Q. You are an ER doctor in a rural farming area in Pennsylvania. A 14 year-old arrives by pedestrian vehicle accompanied by his father and mother. They are incredibly worried about him because he appears to almost be drowning in his own saliva. He had been playing with some friends and when he came into the house he was complaining that his "belly hurt" and they could hear his stomach rumbling. He suddenly complained of severe pain and vomited all over the ground. After that, he became panicky and they decided to take him to the ER. In the ER, his vitals are remarkable for a heart rate of 42. His exam is remarkable for miosis (pupil narrowing), and he appears very sweaty. You are worried about the potential for which of the following?